Provider Demographics
NPI:1487643391
Name:ZALZAL, RABIE H (MD)
Entity type:Individual
Prefix:DR
First Name:RABIE
Middle Name:H
Last Name:ZALZAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:537 S MINERAL ST
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-2936
Mailing Address - Country:US
Mailing Address - Phone:304-788-1274
Mailing Address - Fax:304-788-5154
Practice Address - Street 1:537 S MINERAL ST
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-2936
Practice Address - Country:US
Practice Address - Phone:304-788-1274
Practice Address - Fax:304-788-5154
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV16515207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0073736000Medicaid
WV0073736000Medicaid
E46352Medicare UPIN